Radiology Practices

Radiology’s Nonphysician Expansion

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A new JACR study detailed nonphysician practitioners’ (NPPs) expansion across US radiology practices, mirroring a trend already seen in other parts of healthcare and raising questions about how much further radiology NPPs might expand.

The Study – The study reviewed 2017-2019 Medicare data for nurse practitioners and physician assistants (together “NPPs”) employed by US radiology practices, finding that:

  • Radiology practices employing NPPs increased by 10.5% (228 to 252 practices), while the number of overall radiology practices declined by 36.5% (2,643 to 1,679)
  • As a result, the share of radiology practices with NPPs on staff nearly doubled (8.6% to 15% of US practices)
  • NPP-employing practices expanded their NPP workforce at a much faster rate (+17.5%, 588 to 691) than they added radiologists (+10.4%, 6,596 to 7,282)
  • The growth of urban practices employing NPPs (10% to 17% share) significantly outpaced rural practices (5% to 7% share), despite a greater need for radiology coverage in rural areas
  • Radiology practices were also more likely to employ NPPs if they were larger, staffed more interventional radiologists, or had a high number of early-career radiologists

The study was limited to radiology-only practices, which employ two-thirds of U.S. radiologists, but excludes many academic, hospital-employed, and multi-specialty groups. That said, it’s possible that radiology NPP growth would be even greater if these groups were included.

The Takeaway

Although 85% practices didn’t employ NPPs and radiologists still outnumbered NPPs by a 32:1 ratio (as of 2019 anyway), this study reveals a clear trend towards more practices employing NPPs and rising overall radiology NPP headcounts. That’s probably not surprising given the historical growth of NPPs within other specialties, and radiology’s continued shift towards national and PE-owned practices, but it’s still interesting to see how it’s taking place. 

It’s also interesting that this study wasn’t met with the level of radiologist uproar that we saw the last few times radiology NPPs made it into the industry news cycle. Even though NPPs’ expansion across radiology practices doesn’t mean that they will start encroaching into radiologists’ clinical territory (as some rads fear), it does suggest that we’ll see a lot more blended rad/NPP workforces going forward.

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-- The Imaging Wire team